Association of salivary cortisol and anxiety levels in lichen planus patients.

Background: Oral lichen planus (OLP) is a frequently encountered chronic inflammatory disease of oral mucosa and skin, where the patients often relate the onset and aggravation of oral symptoms to increased levels of stress. Cortisol, also called as "stress hormone" has been used as an indicator in various stress evaluation studies.

Aim: The aim of this cross-sectional study was to determine any association between anxiety and salivary cortisol levels in OLP patients.

Materials And Methods: A total of 20 OLP patients along with same number of age and sex matched healthy controls were included in the study. Saliva was collected from all the subjects between 9.00 to 9.15 am to avoid diurnal variations of cortisol levels. The saliva samples were analysed for cortisol levels by competitive enzyme-linked immunosorbent assay (ELISA) method. Anxiety levels of 40 patients were measured by using Hamilton's anxiety scale. Student's t-test was used to compare the anxiety and salivary cortisol levels between both groups.

Results: The mean salivary cortisol level of the OLP group showed highly significant difference (p<0.001) from the controls. The mean anxiety scores of the OLP group showed highly significant difference (p<0.001) from the controls. A positive correlation was found between anxiety and salivary cortisol levels in the OLP patients.

Conclusion: These findings suggest that anxiety play a vital role in the pathogenesis of OLP, thus besides traditional treatment, psychological support is also needed.